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Upper-airway obstruction after multilevel cervical corpectomy for myelopathy
S E Emery1, M D Smith, H H Bohlman
1Department of Orthopaedics, University Hospitals, Cleveland, Ohio.
The Journal of Bone and Joint Surgery. American Volume
|April 1, 1991
Summary
Patients undergoing multilevel anterior cervical corpectomy face risks of upper airway obstruction due to edema. Pre-existing conditions like myelopathy and smoking increase this risk, requiring careful postoperative airway management.
Area of Science:
- Neurosurgery
- Anesthesiology
- Critical Care Medicine
Background:
- Anterior cervical spine procedures, particularly multilevel corpectomy, are performed for spinal cord decompression.
- Postoperative upper airway obstruction is a potential complication following these surgeries.
Observation:
- Seven patients experienced immediate upper airway obstruction requiring reintubation after anterior cervical spine surgery.
- All patients had moderate to severe myelopathy preoperatively and underwent multilevel corpectomy with arthrodesis.
Findings:
- Edema, not hematoma, was the presumed cause of early airway compromise.
- Two of the seven patients died from obstruction-related complications.
- Risk factors identified include moderate/severe myelopathy, multilevel corpectomy, heavy smoking history, and asthma.
Implications:
- Multilevel corpectomy in patients with myelopathy and pre-existing respiratory conditions necessitates heightened postoperative airway vigilance.
- Careful airway monitoring and management are crucial to mitigate severe outcomes.